Ossification of an intercostal flap after carinal resection: long-term concerns of a 'protection maneuver'.

This CT-scan shows an ossification of the flap of two intercostal muscles 6 months after a carinal resection with reconstruction of the tracheo-bronchial tree using the Barclay’s technique in a 39-year-old patient with a lowerthird tracheal adenoid cystic carcinoma. Some degree of stenosis can also be seen at the level of the right main bronchus. A stent was placed but migrated. The picture is striking, because it looks like a hangman’s noose around the neck (Figs. 1 and 2). Recurrence was ruled out. Two years later the images have not changed. The patient is asymptomatic and continues to lead an active life although there is a slight decrease in lung function tests. European Journal of Cardio-thoracic Surgery 24 (2003) 306 www.elsevier.com/locate/ejcts